Empowering members through diabetes and nutrition education

Authored by Megan Harper, Castlight Diabetes and Nutrition Educator

Diabetes represents a substantial economic burden in the United States. According to the Economic Report, total annual cost of diabetes in 2022 was $412.9 billion and people diagnosed with diabetes account for one of every four dollars spent on healthcare in the U.S. What can we do in health care to help reduce this burden? Engage with Diabetes Self-Management Education and Support (DSMES).

DSMES program, what is it?

A DSMES program empowers members with the knowledge, skills, and support needed to confidently manage their diabetes. DSMES has shown to reduce hospital admissions and readmissions, as well as estimated lifetime health care costs related to a lower risk for complications. A retrospective study examining medical records of over 33,000 patients found average annual health care costs were 39% lower for patients who received DSMES compared to those who had no visits. A systematic review found individuals with type 2 diabetes who received DSMES had a 0.55% reduction in their hemoglobin A1c (A1C) compared to individuals who did not receive DSMES.

The Castlight DSMES program is accredited through Association of Diabetes Care & Education Specialists (ADCES). Accreditation signifies that the DSMES program has been verified by an external organization to meet high national standards for quality and effectiveness in helping individuals with diabetes. Our program education is structured around seven diabetes self-care behaviors, known as the ADCES7 Self-Care Behaviors®, which include:

• Healthy eating
• Physical activity
• Monitoring
• Taking medication
• Problem solving
• Reducing risks
• Healthy coping

Combining DSMES programs with primary care for better outcomes

There are many DSMES programs available, at Castlight we can combine our clinical services with the Vera Whole Health advanced primary care (APC) model to make it really stand out. What makes it better?

• Having the Castlight certified diabetes care and education specialist (CDCES) integrated in the primary care setting allows for more direct contact with the primary care provider which leads to more seamless coordination and collaboration.
• Direct contact with the primary care provider helps push through therapeutic inertia to add on or adjust medications, like insulin, quickly. In addition, the APC model prioritizes health outcomes over reimbursement, so we are able to offer more 1:1 appointments and foster ongoing care to create more personalized health recommendations. 
• Traditional DSMES programs set up with fee for service models are limited to how many hours of care can be received and are limited to mainly group education sessions.  
• We are set up for both, allowing for peer support and individual support. 
• The model has an integrated, multidisciplinary care team which includes a Whole Health Coach and Behavioral Health Clinician to help support lifestyle changes and coping with the stress of managing diabetes.

Our average reduction in A1C for those individuals who completed their DSMES care plan is 1.1% (compared to national average of 0.55%). We work to make small, yet sustainable changes that are attainable, but create a snowball effect with time. We have regular check-in appointments to assess progress and continue to make changes to support overall health goals. In addition, we regularly use technology like continuous glucose monitors to get a deeper insight into a person’s blood sugar throughout the entire day. Our overall goal is to give people with diabetes the knowledge, skills, and confidence to accept responsibility for their self-management resulting in better clinical and quality of life outcomes, increased productivity, and reduced total cost of care. 

Success with the Castlight model

Rebecca*, a new member, came to a care center to establish care. Three years ago, she was diagnosed with diabetes and started on short and long-acting insulin along with Metformin (an oral medication). She expressed frustration with the lack of support she had previously received regarding diabetes management. The Vera Whole Health primary care provider supplied Rebecca with 2 samples of the Libre continuous glucose monitor (CGM) and put in a referral to a Castlight certified diabetes care and education specialist (CDCES). The CDCES educated her on how to best use the CGM and interpret the data, while simultaneously educating on diet and lifestyle changes. With time, Rebecca was able to discontinue her long-acting insulin and her A1c has dropped from 8.9-6.5% (this is the first time her A1c has been under 7% since initial diagnosis 3 years ago), plus she is feeling more confident in her own abilities to manage blood sugars. 

Since our diabetes and nutrition program consists of Registered Dietitians, we are also able to offer patients medical nutrition therapy which harnesses the power of nutrition to treat and manage a variety of health conditions. Members referred for elevated cholesterol experienced an average of 50 point reduction in triglycerides, 40 point reduction in total cholesterol, and a 35 point reduction in LDL cholesterol. In addition, members referred for pre-diabetes have seen an average A1C reduction from 5.9, to 5.6% (out of the pre-diabetes range), a 58 point reduction in triglycerides, and a 4.5% weight loss. 

Through empathetic listening and more touchpoints focusing on small changes, we are able to build relationships with patients to improve their health outcomes and ultimately help to lower their total cost of care. 

Learn more about all Castlight solutions, including the Diabetes Self-Management Education and Support (DSMES) Program, or request a demo today.  

*Name changed for privacy